Classic Yacht Regatta 2015 Day 1
Arm is safer access point than groin for catheter-based heart procedures
March 17, 2015 - Patients with acute coronary syndrome undergoing coronary angiogram, a procedure used to assess blockages in the heart's arteries, had a significantly lower risk of major bleeding and death if their interventional cardiologist accessed the heart through an artery in the arm rather than the groin, according to research presented at the American College of Cardiology's 64th Annual Scientific Session. Study authors said the results should prompt a re-evaluation of clinical guidelines and that the arm, currently used in a minority of cases in the United States, should be the preferred approach for most catheter-based heart procedures.
The study did not show a significant reduction in one of its two primary endpoints, a composite rate of death, heart attack or stroke 30 days after a catheterization procedure. However, the second primary endpoint, which included those events plus major bleeding, showed a significant reduced risk in patients randomized to receive a catheter via the arm, known as the radial approach, rather than the groin, known as the femoral approach. In addition, patients receiving a catheter via the groin faced a significantly higher risk of death, which was driven by increased bleeding complications in these patients, the study authors said.
"I believe the evidence from our study should compel a switch to the radial approach as the preferred method," said Marco Valgimigli, M.D., Ph.D., associate professor of cardiology and senior interventional cardiologist at the Erasmus University Medical Center in the Netherlands and the study's lead author. "I hope that a new generation of interventional cardiologists will be specifically trained in the radial approach and that more medical centers will build up their expertise in this procedure."
The study is the first large trial to show radial access improves patient outcomes and that it reduces dangerous bleeding beyond the bleeding that can occur near where the catheter is inserted. U.S. interventional cardiologists currently use the arm for catheter-based heart procedures in less than 15 percent of cases. The approach is more common in Europe, where interventional cardiologists use the arm roughly half of the time or more.
"This study shows that interventional cardiologists who are experienced with the radial approach have nothing to lose and everything to gain by using the arm as the access point for these procedures," Valgimigli said. In addition to improving outcomes, the radial approach can also save on medical costs because it typically results in a quicker recovery and shorter hospital stay, Valgimigli said.
During a coronary angiogram--performed in more than 1 million people in the United States each year--an interventional cardiologist examines the heart's arteries using miniscule medical equipment threaded to the heart through a catheter placed in an artery in the groin or arm. If a blockage is found, the surgeon typically uses the same catheter to inflate or expand a small device to push aside plaque and open the artery, a procedure known as angioplasty or stenting.
The study randomized more than 8,400 angiogram patients at 78 hospitals in four European countries to receive angiogram via the arm or the groin. All study participants had acute coronary syndrome, a condition that includes the two types of heart attack--ST-elevation myocardial infarction and non-ST elevation myocardial infarction--or unstable angina, a type of severe chest pain that is due to the buildup of plaque in the heart's arteries.
Patients receiving radial access suffered major bleeding, death, heart attack or stroke within 30 days in 9.8 percent of cases as compared to 11.7 percent in those receiving femoral access. The difference was largely attributable to major bleeding, which occurred in 1.6 percent of patients receiving radial access and 2.3 percent of patients receiving femoral access, and death, which occurred in 1.6 percent of patients receiving radial access and 2.2 percent of patients receiving femoral access.
Study authors attributed the fact that the study did not meet its other co-primary endpoint to a higher-than-usual bar for statistical significance, a result of the inclusion of two co-primary endpoints in the study rather than only one. The study found no differences with respect to rates of heart attack or stroke.
Interventional cardiologists have typically favored catheter access through the groin because it involves a larger artery that is less prone to spasm, an event that can limit the ability to move medical equipment through the catheter. Although the artery in the arm is closer to the surface and thus easier to access, the artery's smaller size makes the radial approach more technically difficult and requires the use of smaller equipment.
Because the radial approach is more difficult to perform, the study showed the hospital's level of experience with this method had a substantial impact on patient outcomes. To build the level of experience necessary to maximize the benefits of the radial approach, a given surgeon should use the radial approach in at least 80 percent of cases, Valgimigli said. However, the femoral approach is still appropriate for certain types of procedures that require the use of larger equipment, such as transcatheter aortic valve implantation or TAVI.
The study, called the Minimizing Adverse Hemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX Program (MATRIX), also tested the effects of the anticoagulant drug Bivalirudin. Those results are being reported separately.
The above story is based on materials provided by American College of Cardiology.
Call to change recycling standards as 3-D printing expands
March 17, 2015 - The 3-D printing revolution has changed the way we think about plastics. Everything from children's toys to office supplies to high-value laboratory equipment can be printed. The potential savings of producing goods at the household- and lab-scale is remarkable, especially when producers use old prints and recycle them.
Buying plastic filament for printing can be expensive, says Joshua Pearce, the lead researcher in the Open Sustainability Technology group at Michigan Technological University. Pearce and his students have whittled the cost of printing to ten cents per kilogram -- down from $30 per kilogram.
They made this leap by recycling plastic that had already been printed, using a recyclebot and plastic resin codes developed by the team.
In a new paper from the research group, published inResources, Conservation and Recycling, the authors lay out how they achieved this price reduction and how to recycle 3-D printed objects more broadly.
"The centralized paradigm of both manufacturing and recycling is being challenged by the rise of 3D printing," Pearce says, explaining that labeling and reusing materials is voluntary.
Current labeling schemes, however, are not detailed enough for 3-D printed recycling. Plastic is not just plastic; there are many kinds, and specific polymers behave in specific ways -- which makes a big difference for 3-D printing.
"We want to know about polymers the same way a chemist would," Pearce says, admitting that the seven codes in the US recycling system fall short. In comparison, China has 140 codes for different polymers. "Currently, the most common 3-D printed plastics are grouped in the category seven polymers in the US," he adds.
That seven category is the catch-all group and means little as a label. Most widely used and conventionally produced plastics fall into the first and second categories -- the same groups that cover plastic water bottles and milk jugs. These can be recycled for 3-D printing, but the two most common plastics for 3-D printing are PLA (polylactic acid) and ABS (acrylonitrile butadiene styrene). PLA is often used as biodegradable dinnerware and ABS is the hard plastic of Lego blocks. Although they're distinctly different, being lumped with so many others in the seven categories makes it difficult to reuse these plastics in 3-D printing.
To overcome these issues, Pearce and his team developed a new resin code identification system based on the Chinese codes. They focused on polymers that could be recycled in 3-D printing and made the system expandable to accommodate innovations in printing and plastics.
"We also demonstrated how to incorporate recycling symbols into 3-D printed objects using open-source and parametric scripts for our new print codes," Pearce says. The scripts are freely available on Appropedia.
The labels themselves are novel in 3-D printing. Standard recycling labels are small, slightly raised and often placed on the bottom or another convenient location. But with 3-D printing, the labels can be woven into the design itself. A pencil holder can reveal its secret polymer type as light shines through its plastic bottom or a broken screwdriver handle can be cracked open to show its code number. Neither is possible with conventional manufacturing.
The inventive ways to use recycling labels along with the new code system and free scripts are a big step towards better 3-D printing recycling, which is good for the environment. Pearce hopes to make the practice widespread.
"To make this actually happen, the coders for the slicing software need to make this an option," he says. "So we're sharing the source codes so they can incorporate them into their software for free, so everyone can use it."
Emily J. Hunt, Chenlong Zhang, Nick Anzalone, Joshua M. Pearce. Polymer recycling codes for distributed manufacturing with 3-D printers. Resources, Conservation and Recycling, 2015; 97: 24 DOI:10.1016/j.resconrec.2015.02.004 Image: Light shines through the bottom of a 3-D printed pencil holder, revealing its polymer resin code for recycling. Credit: Joshua Pearce
Sunday Morning Birdwatching with PNHA
Would you like to know more about our local birds? Our guides can help you discover the birdlife in these wonderful bushland reserves.
26 April, Warriewood Wetlands, Warriewood
24 May, Chiltern Track, Ingleside
16 August, Chiltern Track (Wildflower study walk with a later start)
20 September, Irrawong Reserve, Warriewood
15 November, Warriewood Wetlands, Warriewood
Our birdwalks start at 7.30 or 8am and last for a couple of hours. Bring binoculars and morning tea for afterwards if you like. Older children welcome.
Contact us to book and get details for each walk. Email pnhabirdwatching@gmail.com or ph: 0439 409 202 / 0402 605 721.
Whale fossil, 17 million years old, provides first exact date for East Africa's puzzling uplift
March 17, 2015 - Uplift associated with the Great Rift Valley of East Africa and the environmental changes it produced have puzzled scientists for decades because the timing and starting elevation have been poorly constrained. Now paleontologists have tapped a fossil from the most precisely dated beaked whale in the world -- and the only stranded whale ever found so far inland on the African continent -- to pinpoint for the first time a date when East Africa's mysterious elevation began.
The 17 million-year-old fossil is from the beaked Ziphiidae whale family. It was discovered 740 kilometers inland at an elevation of 620 meters in modern Kenya's harsh desert region, said vertebrate paleontologist Louis L. Jacobs, Southern Methodist University, Dallas.
At the time the whale was alive, it would have been swimming far inland up a river with a low gradient ranging from 24 to 37 meters over more than 600 to 900 kilometers, said Jacobs, a co-author of the study.
The study, published in the Proceedings of the National Academy of Sciences, provides the first constraint on the start of uplift of East African terrain from near sea level.
"The whale was stranded up river at a time when east Africa was at sea level and was covered with forest and jungle," Jacobs said. "As that part of the continent rose up, that caused the climate to become drier and drier. So over millions of years, forest gave way to grasslands. Primates evolved to adapt to grasslands and dry country. And that's when -- in human evolution -- the primates started to walk upright."
Identified as a Turkana ziphiid, the whale would have lived in the open ocean, like its modern beaked cousins. Ziphiids, still one of the ocean's top predators, are the deepest diving air-breathing mammals alive, plunging to nearly 10,000 feet to feed, primarily on squid.
In contrast to most whale fossils, which have been discovered in marine rocks, Kenya's beached whale was found in river deposits, known as fluvial sediments, said Jacobs, a professor in the Roy M. Huffington Department of Earth Sciences of SMU's Dedman College of Humanities and Sciences. The ancient large Anza River flowed in a southeastward direction to the Indian Ocean. The whale, probably disoriented, swam into the river and could not change its course, continuing well inland.
"You don't usually find whales so far inland," Jacobs said. "Many of the known beaked whale fossils are dredged by fishermen from the bottom of the sea."
Determining ancient land elevation is very difficult, but the whale provides one near sea level.
"It's rare to get a paleo-elevation," Jacobs said, noting only one other in East Africa, determined from a lava flow.
Beaked whale fossil surfaced after going missing for more than 30 years
The beaked whale fossil was discovered in 1964 by J.G. Mead in what is now the Turkana region of northwest Kenya.
Mead, an undergraduate student at Yale University at the time, made a career at the Smithsonian Institution, from which he recently retired. Over the years, the Kenya whale fossil went missing in storage. Jacobs, who was at one time head of the Division of Paleontology for the National Museums of Kenya, spent 30 years trying to locate the fossil. His effort paid off in 2011, when he rediscovered it at Harvard University and returned it to the National Museums of Kenya.
The fossil is only a small portion of the whale, which Mead originally estimated was 7 meters long during its life. Mead unearthed the beak portion of the skull, 2.6 feet long and 1.8 feet wide, specifically the maxillae and premaxillae, the bones that form the upper jaw and palate.
The researchers reported their findings in "A 17 million-year-old whale constrains onset of uplift and climate change in East Africa" online at the PNAS web site.
Modern cases of stranded whales have been recorded in the Thames River in London, swimming up a gradient of 2 meters over 70 kilometers; the Columbia River in Washington state, a gradient of 6 meters over 161 kilometers; the Sacramento River in California, a gradient of 4 meters over 133 kilometers; and the Amazon River in Brazil, a gradient of 1 meter over 1,000 kilometers.
Henry Wichura, Louis L. Jacobs, Andrew Lin, Michael J. Polcyn, Fredrick K. Manthi, Dale A. Winkler, Manfred R. Strecker, Matthew Clemens. A 17-My-old whale constrains onset of uplift and climate change in east Africa.Proceedings of the National Academy of Sciences, 2015; 201421502 DOI:10.1073/pnas.1421502112
Image: A 17-million-year-old whale fossil stranded far inland in Kenya now sheds light on the timing and starting elevation of East Africa's puzzling tectonic uplift, says paleontologist Louis Jacobs, Southern Methodist University, Dallas, who rediscovered the fossil. Credit: Southern Methodist University
Talking under water
18 March 2015
Right: Sirius one of the University of Sydney's autonomous underwater vehicles
In a first of its kind study, an international research team onboard Schmidt Ocean Institute's research vessel Falkor will conduct a data gathering expedition using coordinated groups of underwater robotics.
The team, led byDr. Oscar Pizarrofrom the University of Sydney 's Australian Centre for Field Robotics, received support from the Schmidt Ocean Institute to visit Scott Reef, 400 kilometers north of Broome in the Timor Sea. The remote site will be used as a test site for experiments aimed at expanding the electronic view of the seafloor and overlying waters.
The team comprised of engineers and scientists from the University of Sydney, James Cook University, Woods Hole Oceanographic Institution, University of Rhode Island, and University of Michigan aim to expand and improve techniques for efficiently coordinating deployments of multiple exploratory vehicles and tools.
"We believe this is a big step in pushing oceanographic technology forward," said chief engineer, Dr. Pizarro. The work will bring engineers closer to being able to leave groups of robotic vehicles unattended for long stretches of time to accomplish tasks like detailed seafloor mapping and chemical analyses across wide areas. This could reduce both costs and the need for scientists to travel to these remote areas, while at the same time, improving ocean exploration by increasing observations.
Autonomous underwater vehicles (AUVs) capable of taking photos and collecting water column measurements at various depths will be used along with autonomous surface vehicles (ASVs) and gliders. These vehicles come in a variety of forms, including some that use solar power and other vehicles that rise and fall with wave action.
"The team 's ultimate vision is to be able to deploy complementary groups of vehicles to accomplish key tasks, that would allow a ship to move to another area for separate work,"says Dr Pizarro.
"The expedition will be in stark contrast to typical research cruises where opportunities for engineering experimentation and testing are rare."
PITTWATER WEATHER STATION LAUNCHED
An idea was born
Frustrated at being unable to obtain Local Pittwater Actual weather from any source the means to achieve such information was investigated. (All current internet weather sites give Terrey Hills weather even when you request one anywhere around Pittwater)
Through the Federal Minister for The Environment, referred to the Bureau of Meteorology to be told that just one station would cost $29,000 and that no funding was available – that was a red rag to a bull.
This is despite the fact that there are no BoM Coastal Weather Stations between North Head and Norah Head – a distance of 67Kms. Going south there are stations every 11 – 30Kms to Kiama.
Without any Government assistance, private equity was volunteered by a very generous local willing to give back something to our idyllic Pittwater.
Not only is he funding one station – the aim is to eventually have 5 -6 around Pittwater.
This data will benefit sailors, fishermen, power boats, seaplanes, Marine Rescue, Maritime, Water Police, National Parks, the Rural Fire Service and yacht clubs.
On Saturday 21st February, 2015 the first station was commissioned at Observation Point, Palm Beach.
This website is most comprehensive with the data available in various formats including gauges that give analog and digital readings: pittwaterweather.com/Cumulus/Observation
Webcams will be incorporated subsequently to give a birds-eye-view.
Permission is pending from Rob Stokes – State Member for the Environment – to position one station on Barrenjoey Lighthouse.
This will give both coastal and Pittwater coverage.
Other sites will follow when siting permission is obtained.
Report by Rohan Walter
